Provider Demographics
NPI:1356184188
Name:QUALITY CARE CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:QUALITY CARE CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DANA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:435-465-5009
Mailing Address - Street 1:97 S MAIN ST # 117
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-2526
Mailing Address - Country:US
Mailing Address - Phone:435-465-5009
Mailing Address - Fax:
Practice Address - Street 1:1950 S HIGHWAY 89 STE B
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:UT
Practice Address - Zip Code:84302-4459
Practice Address - Country:US
Practice Address - Phone:435-465-5009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty